Use of eltrombopag after romiplostim in primary immune thrombocytopenia.

Abstract:

:The thrombopoietin receptor agonists (THPO-RAs), romiplostim and eltrombopag, are effective and safe in immune thrombocytopenia (ITP). However, the value of their sequential use when no response is achieved or when adverse events occur with one THPO-RA has not been clearly established. Here we retrospectively evaluated 51 primary ITP adult patients treated with romiplostim followed by eltrombopag. The median age of our cohort was 49 (range, 18-83) years. There were 32 women and 19 men. The median duration of romiplostim use before switching to eltrombopag was 12 (interquartile range 5-21) months. The reasons for switching were: lack of efficacy (n = 25), patient preference (n = 16), platelet-count fluctuation (n = 6) and side-effects (n = 4). The response rate to eltrombopag was 80% (41/51), including 67% (n = 35) complete responses. After a median follow-up of 14 months, 31 patients maintained their response. Efficacy was maintained after switching in all patients in the patient preference, platelet-count fluctuation and side-effect groups. 33% of patients experienced one or more adverse events during treatment with eltrombopag. We consider the use of eltrombopag after romiplostim for treating ITP to be effective and safe. Response to eltrombopag was related to the cause of romiplostim discontinuation.

journal_name

Br J Haematol

authors

González-Porras JR,Mingot-Castellano ME,Andrade MM,Alonso R,Caparrós I,Arratibel MC,Fernández-Fuertes F,Cortti MJ,Pascual C,Sánchez-González B,Bernat S,Fuertes-Palacio MA,Vázquez-Paganini JA,Olivera PE,Alvarez-Román MT,Jarq

doi

10.1111/bjh.13266

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

111-6

issue

1

eissn

0007-1048

issn

1365-2141

journal_volume

169

pub_type

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